Provider Demographics
NPI:1083054761
Name:CHUMLEY-JONES, HEATHER NICOLE (MSRPT, RYT200)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:NICOLE
Last Name:CHUMLEY-JONES
Suffix:
Gender:F
Credentials:MSRPT, RYT200
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2877 DONCASTER DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3409 SALTERBECK CT
Practice Address - Street 2:SUITE 202
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7117
Practice Address - Country:US
Practice Address - Phone:843-972-0671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist